Alterations in plasma soluble vascular endothelial growth factor receptor-1 (sFlt-1) concentrations during coronary artery bypass graft surgery: relationships with post-operative complications

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• 作者：Yves Denizot (1)
  Alexandre Leguyader (2)
  Elisabeth Cornu (2)
  Marc Laskar (2)
  Isabelle Orsel (3)
  Christelle Vincent (1)
  Nathalie Nathan (3)
  
• 刊名：Journal of Cardiothoracic Surgery
• 出版年：2008
• 出版时间：December 2008
• 年：2008
• 卷：3
• 期：1
• 全文大小：405KB
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• 作者单位：Yves Denizot (1)
  Alexandre Leguyader (2)
  Elisabeth Cornu (2)
  Marc Laskar (2)
  Isabelle Orsel (3)
  Christelle Vincent (1)
  Nathalie Nathan (3)
  
  1. UMR CNRS 6101, Centre National de la Recherche Scientifique, Universit茅 de Limoges, France
  2. Service de Chirurgie Thoracique et Cardiovasculaire, CHU Dupuytren, Limoges, France
  3. Service d'Anesth茅sie R茅animation Chirurgicale, CHU Dupuytren, Limoges, France
  

文摘

Background Plasma concentrations of sFlt-1, the soluble form of the vascular endothelial growth factor receptor (VEGF), markedly increase during coronary artery bypass graft (CABG) surgery with extracorporeal circulation (ECC). We investigated if plasma sFlt-1 values might be related to the occurrence of surgical complications after CABG. Methods Plasma samples were collected from the radial artery catheter before vascular cannulation and after opening the chest, at the end of ECC just before clamp release, after cross release, after weaning from ECC, at the 6th and 24th post-operative hour. Thirty one patients were investigated. The presence of cardiovascular, haematological and respiratory dysfunctions was prospectively assessed. Plasma sFlt-1 levels were measured with commercially ELISA kits. Results Among the 31 investigated patients, 15 had uneventful surgery. Patients with and without complications had similar pre-operative plasma sFlt-1 levels. Lowered plasma sFlt-1 levels were observed at the end of ECC in patients with haematological (p = 0.001, ANOVA) or cardiovascular (p = 0.006) impairments, but not with respiratory ones (p = 0.053), as compared to patients with uneventful surgery. Conclusion These results identify an association between specific post-CABG complication and the lower release of sFlt-1 during ECC. sFlt-1-induced VEGF neutralisation might, thus, be beneficial to reduce the development of post-operative adverse effects after CABG.